Adult type granulosa cell tumor of the testis with a heterologous sarcomatous component: case report and review of the literature

Abstract

Adult testicular granulosa cell tumors are rare sex cord- stromal tumors of which only 45 have been previously reported. As compared with their ovarian counterparts, these tumors may follow a more aggressive course because the proportion of malignant cases is higher. We report here a unique case of a 78-year Caucasian with a left sided adult type granulosa cell tumor with a heterologous sarcomatous tumor component. A heterologous sarcomatous component has occasionally been observed in ovarian tumors but never in testicular granulosa cell tumors. The sarcomatous component showed a higher number of mitotic figures (1/Hpf) and a marked proliferation rate (up to 50% Ki 67 positive cells) compared with the granulosa type tumor component. CD 99 and the progesterone receptor were positive in both tumor components, inhibin and calretinin only in the granulosa cells, and pancytokeratin only in the sarcomatouse one. Key words: testis - ovary - granulosa cells - sarcoma - inhibin Runing title: testicular sarcomatous granulosa tumor.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/6959043481207016

Adult granulosa cell tumors of bilateral ovaries with pure cystic presentation

“…On ommunohistochemical examination, adenocarcinoma cells are positive for epithelial membrane antigen and cytokeratin. [18] …”

Adult-type granulosa cell tumour of the testis: Report of a case and review of the literature

“…The adult-type GCT is extremely rare in the testis, Schubert et al [35] have found 43 cases in the literature [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] and we were able to find three more recent cases in PubMed ( Table 1 ) [2] , [36] . However, in most of the reports these tumours are only the object of immunohistochemical or cytogenetic investigations; thus, the clinical data are missing partially [5] , [11] , [22] , [24] .…”

Adult testicular granulosa cell tumour: an extremely rare entity

“…Macrofollicles ought to be present and the presence of the Call-Exner bodies facilitates the correct diagnosis; however, they are not always found and thus, are not indispensable to diagnosis 2. Granulosa cells should represent the biggest part of the tumour.…”

“…Vascular invasion, infiltrative margins, necrosis, atypical mitotic figures and high mitotic index can be associated with malignancy, but as single criteria they are not predictive 2. The only reliable predictor of malignancy in GCT, as in all other stromal tumours, is a diameter >5 cm 4…”